The Cannabis Expectancy Questionnaire for Men who have Sex with Men (CEQ-MSM): A measure of substance-related beliefs

Objective

Substance-related expectancies are associated with substance use and post-substance use thoughts, feelings and behaviours. The expectancies held by specific cultural or sub-cultural groups have rarely been investigated. This research maps expectancies specific to gay and other men who have sex with men (MSM) and their relationship with substance patterns and behaviours following use, including sexual practices (e.g., unprotected anal intercourse). This study describes the development of a measure of such beliefs for cannabis, the Cannabis Expectancy Questionnaire for Men who have Sex with Men (CEQ-MSM).

Method

Items selected through a focus group and interviews were piloted on 180 self-identified gay or other MSM via an online questionnaire.

Results

Factor analysis revealed six distinct substance reinforcement domains (“Enhanced sexual experience”, “Sexual negotiation”, “Cognitive impairment”, “Social and emotional facilitation”, “Enhanced sexual desire”, and “Sexual inhibition”). The scale was associated with consumption patterns of cannabis, and in a crucial test of discriminant validity not with the consumption of alcohol or stimulants.

Conclusions

The CEQ-MSM represents a reliable and valid measure of outcome expectancies, related to cannabis among MSM. Future applications of the CEQ-MSM in health promotion, clinical settings and research may contribute to reducing harm associated with substance use among MSM, including HIV transmission.     

The Amyl Nitrite Expectancy Questionnaire for Men who have Sex with Men (AEQ-MSM): a measure of substance-related beliefs

A measure of perceived reinforcement associated with amyl nitrite was developed and evaluated among gay and bisexual men. This is the first known expectancy measure to date for this drug class. The Amyl Nitrite Expectancy Questionnaire for Men who have Sex with Men (AEQ-MSM) was completed online by 102 gay and bisexual men, between 2006 and 2008 in Queensland, Australia. The AEQ-MSM demonstrated good psychometric properties and was associated with consumption patterns. Factor analysis revealed three distinct reinforcement domains: "Enhanced sexual desire and pleasure," "Disorientation," and "Sexual negotiation." Limitations include sampling via self-selection, recruitment through health centers and self-report data. Implications for sexual activity and risk-taking, including reducing associated harm (e.g., HIV transmission), and future directions are discussed.     

The Amyl Nitrite Expectancy Questionnaire for Men who have Sex with Men (AEQ-MSM): A Measure of Substance-Related Beliefs

A measure of perceived reinforcement associated with amyl nitrite was developed and evaluated among gay and bisexual men. This is the first known expectancy measure to date for this drug class. The Amyl Nitrite Expectancy Questionnaire for Men who have Sex with Men (AEQ-MSM) was completed online by 102 gay and bisexual men, between 2006 and 2008 in Queensland, Australia. The AEQ-MSM demonstrated good psychometric properties and was associated with consumption patterns. Factor analysis revealed three distinct reinforcement domains: “Enhanced sexual desire and pleasure,” “Disorientation,” and “Sexual negotiation.” Limitations include sampling via self-selection, recruitment through health centers and self-report data. Implications for sexual activity and risk-taking, including reducing associated harm (e.g., HIV transmission), and future directions are discussed.     

Social Stressors and Intoxicated Sex Among an Online Sample of Men who have Sex with Men (MSM) Drawn from Seven Countries

Background: Rates of drug and alcohol use are higher among men who have sex with men (MSM) than the general adult male population, and are often associated with increased sexual risk-taking. Objectives: We aim to examine the prevalence of drunk or high sex and their associations with socio-demographic characteristics, gay social network size, and social stress among an online sample of MSM drawn from seven countries. Methods: Sexually-active MSM aged over 18 residing in Australia, Brazil, Canada, South Africa, Thailand, the United Kingdom, or the United States were recruited through Facebook for a quantitative survey (n = 2,403) in 2012. Two outcomes were examined via logistic regression: reporting being buzzed/drunk at last sex, and reporting being high at last sex. Results: Results highlight the role of social stressors in shaping drug use among MSM. Results were context-specific, though commonalities were seen across countries. Being in a male–male sexual relationship was associated with lower odds of being buzzed/drunk at last sex in five countries. Higher scores on measures of external homonegative discrimination and internalized homonegativity were associated with greater odds of reporting being high at last sex in three countries. Conclusions/Importance: Social networks and minority stressors can have significant effects on drug use and sex while drunk or high. This points to the importance of focusing on structural issues when designing interventions for MSM aimed at reducing the transmission of HIV and other STIs.     

Development and Preliminary Validation of the Drinking Expectancy Sexual Vulnerabilities Questionnaire (DESV-Q): A Purpose-Specific Instrument for Rape-Perception Research

Background: Alcohol expectancies likely play a role in people's perceptions of alcohol-involved sexual violence. However, no appropriate measure exists to examine this link comprehensively. Objective: The aim of this research was to develop an alcohol expectancy measure which captures young adults' beliefs about alcohol's role in sexual aggression and victimization. Method: Two cross-sectional samples of young Australian adults (18–25 years) were recruited for scale development (Phase 1) and scale validation (Phase 2). In Phase 1, participants (N = 201; 38.3% males) completed an online survey with an initial pool of alcohol expectancy items stated in terms of three targets (self, men, women) to identify the scale's factor structure and most effective items. A revised alcohol expectancy scale was then administered online to 322 young adults (39.6% males) in Phase 2. To assess the predictive, convergent, and discriminant validity of the scale, participants also completed established measures of personality, social desirability, alcohol use, general and context-specific alcohol expectancies, and impulsiveness. Results: Principal axis factoring (Phase 1) and confirmatory factor analysis (Phase 2) resulted in a target-equivalent five-factor structure for the final 66-item Drinking Expectancy Sexual Vulnerabilities Questionnaire (DESV-Q). The factors were labeled (1) Sexual Coercion, (2) Sexual Vulnerability, (3) Confidence, (4) Self-Centeredness, and (5) Negative Cognitive and Behavioral Changes. The measure demonstrated effective items, high internal consistency, and satisfactory predictive, convergent, and discriminant validity. Conclusions: The DESV-Q is a purpose-specific instrument that could be used in future research to elucidate people's attributions for alcohol-involved sexual aggression and victimization.     

Validation of the Comprehensive Effects of Alcohol Questionnaire in Older Adults

Background: Alcohol expectancies have been established as an important construct in the prediction of alcohol use among younger adults, but there is little understanding about the perceived expected effects of consuming alcohol in older adults. Beliefs about the expected effects of alcohol may be quite different in older adults compared to young adults, which may also play a different role in their drinking behavior. In older cohorts there may be stigma may be associated with drinking and the nature of drinking experiences may differ to those of younger adults. Existing measures of expectancies are based on the perspectives of younger adults and therefore warrant validation in an older sample. Objectives: The aim of this study is to validate the comprehensive effects of alcohol questionnaire (CEOA) in a sample of older adults, and to investigate the relationships between alcohol expectancies, their evaluations and alcohol use. Methods: A sample of community dwelling older adults (N?=?473) completed self-report measures assessing drinking behavior and alcohol expectancies. Exploratory factor analysis, confirmatory factor analysis, and hierarchical multiple regressions were conducted. Results: The final model of the CEOA supported two global dimensions of positive and negative expectancies, and showed excellent goodness-of-fit and internal consistency. Male drinkers were more likely to endorse positive expectancies and favorable evaluations of positive and negative expectancies. Favorable evaluations of positive expectancies were the strongest predictors of drinking frequency and quantity. Conclusions/Importance: The results support for the empirical validity of a two-factor expectancy model consisting of a 10-item negative expectancy factor and a 10-item positive expectancy factor. This more concise version could offer a more acceptable and time efficient measure of expectancies and valuations for older adults. Furthermore, the study provides important findings for the role of evaluations in their prediction of alcohol use.     

Validation of the Drinking Motives Questionnaire (DMQ) in older adults

Drinking motives have been established as an important construct in the prediction of alcohol use and drinking problems among younger adults, but there is little understanding about the drinking motivations of older adults. Although emerging evidence shows the importance of studying older adults' own reasoning for their alcohol consumption, measures that have been used to assess such reasons lack psychometric assessment. This study aims to validate the three-dimensional structure of the Drinking Motives Questionnaire (DMQ) in older adults and to investigate the relationships between drinking motives and alcohol use. A sample of community dwelling older adults (N = 370) completed self-report measures assessing drinking behavior and motives for drinking. Using confirmatory factor analysis, the results supported a three-factor model of drinking motives. Multi-group analysis of invariance showed support for configural and metric invariance, and partial support was met for scalar invariance. Social motivations for drinking were the most frequently endorsed, followed by enhancement, and coping motives. Males reported more frequent drinking for each of the three motives. Social motives were consistently related to drinking behaviors and coping had a direct relationship to drinking problems. Overall, the study shows that the DMQ has promise as a measure for use with older adults.     

The Relationship Between Parent Drinking and Adolescent Drinking: Differences for Mothers and Fathers and Boys and Girls

Background: Gender differences in the relationship between parent drinking and adolescent drinking are poorly understood. As parental alcohol use is a primary early exposure to alcohol for adolescents, it is important to understand how consequences may differ for adolescent males and females. Objectives: The aim of this paper was to examine gender differences in the relationship between mother’s and father’s heavy episodic drinking, and its combination, and adolescent drinking. Methods: The sample included 2,800 14–15?year olds (48.9% female) living in two-parent households from the Longitudinal Study of Australian Children. The adolescent outcome measure was having had an alcoholic drink in the past year. Mothers and fathers self-reported their frequency of heavy episodic drinking. Covariates included parents’ education, smoking, non-English-speaking background, and symptoms of psychological distress. Logistic regression was used to examine the hypotheses. Results: After adjustment for covariates, both mothers’ and fathers’ heavy episodic drinking significantly increased the likelihood of adolescent drinking. Moreover, fathers’ heavy drinking was more strongly related to adolescent drinking for girls. However, there were no gender differences in the relationship between mothers’ drinking and adolescent drinking, and the combination of mothers’ and fathers’ drinking was not more risky than heavy drinking in either parent alone. Conclusions: Parent heavy episodic drinking is a risk factor for adolescent drinking, after controlling for potential confounding variables. Results suggest that girls may be especially vulnerable to parent heavy drinking in early adolescence. This variation should be considered in the design and evaluation of family-based interventions to prevent adolescent drinking.     

Validation of the Drinking Context Scale (DCS-9) for use with non-adjudicated first-year college students

The Drinking Context Scale (DCS-9) has been used to measure the impact of drinking during social, emotional, and situational contexts. Psychometric properties remain unevaluated in a population of non-adjudicated first-year college students in the southeast. Liseral 8.8 was used to test the factorial validity of the DCS, using Confirmatory Factor Analysis. The original three factor model for the DCS represented acceptable fit to the data (χ² = 36.72, df = 24, p = 0.047, CFI = 0.991, SRMR = .0406) supporting its use with first-year college students. Invariance between gender, ethnic group, and geographical regions should be examined by future researchers.     

Patterns of Drinking Initiation Among Latino Youths: Cognitive and Contextual Explanations of the Immigrant Paradox

ABSTRACT

This study examined the immigrant paradox in drinking initiation among Latino youths and tested contextual (i.e., family, peer) and cognitive (i.e., alcohol expectancies, risk-taking) explanations of this pattern. A sample of 129 first- and second-generation (73%) youths completed the study. The estimated odds of starting to drink were 2.5 (95% confidence interval [CI]: 1.10–5.9) times higher for second-generation teens compared to first-generation youths. Negative expectancy valuations and perceptions of peer substance use simultaneously explained the generational increase in drinking initiation. Addressing these tractable mechanisms represents opportunities to delay initiation and help reduce emerging disparities among Latino youth.     

The Parental Bond and Alcohol Use Among Adolescents: The Mediating Role of Drinking Motives

Background: Alcohol use and alcohol-related problems represent a significant health concern. Few empirical researches focused on understanding the interrelationships and links between the parental bond, drinking motives, and alcohol use during adolescence.

Objectives: The present study examined the relationships between a supportive parental bond, drinking motives, and alcohol use, with a focus on the role of mediation.

Methods: The sample comprised 298 adolescents, aged from 16 to 20 years. The technique of structural equation modelling (SEM) was used to assess the direct and indirect effects of the parental bond on alcohol use among adolescents through motives for drinking.

Results: The relationship between the parental bond and frequency of alcohol use by adolescents was not mediated by any motives for drinking, neither for males nor females. Regarding the relationships between the parental bond and quantity of adolescent alcohol consumption, findings for females showed significant indirect effects of maternal bond on alcohol quantity, when coping, enhancement, and social drinking motives were entered as mediator variables. Rather, paternal bond did not predict drinking quantity, not even indirectly. On the contrary, results for males indicated that the parental bond was neither directly nor indirectly associated with adolescent alcohol use.

Conclusions/Importance: Mothers are the relational fulcrum of the family, while fathers seem to maintain a more peripheral position. Gender differences are discussed on the basis of the different cultural and parental socialisation processes that operate for male and female adolescents.     

A confirmatory approach to understanding the four-factor structure of the Adolescent Drinking Index: Evidence for a brief version

The purpose of this study was to examine the psychometric properties of the original version of the Adolescent Drinking Index (ADI), and to examine the fit of a series of confirmatory factor analysis models to arrive at an abbreviated version that can be easily administered in settings with limited time for assessment. These aims were examined in a sample of 740 adolescents (M_age = 15.26; 58.5% males) who completed the ADI during an emergency department visit. Results suggested that the four-domain design did not fit the data adequately. Results, however, demonstrated good fit for an 8-item adapted version with a four-factor structure: interpersonal, social, psychological, and physical indicators. This abbreviated version was also associated with outcomes such as hangover, alcohol withdrawal, and substance use. Findings from this study provide support for the use of an abbreviated version of the ADI for screening adolescents and referring them to appropriate interventions.     

Club Drugs as Causal Risk Factors for HIV Acquisition Among Men Who Have Sex with Men: A Review

We reviewed medical and psychology databases for articles published between January 1980 and August 2005 demonstrating associations between HIV_Sexually Transmitted Infection risk and club drug use. Seventy-four articles were reviewed, of which 30 provided adjusted risk ratios for associations between HIV_sexually transmitted infection risk and club drug use among men who have sex with men. Definitions and lists of club drugs were broad and inconsistent. We constructed a conceptual framework of biologically plausible pathways for causation. Using Hill's criteria to examine club drugs as causal risk factors for HIV, we found the most evidence for methamphetamine and volatile nitrites; however, more studies are needed.     

Deconstructing the Complexity of Substance Use among Young Men Who have Sex with Men (YMSM) by Optimizing the Role of Qualitative Strategies in a Mixed Methods Study

Qualitative data can be a powerful tool in developing interventions for substance use and other HIV-risk behaviors. Mixed methods design offers researchers the ability to obtain data that provides both breadth and depth to their research questions. However, the integration of qualitative data in mixed methods research has been limited. This paper describes the qualitative study design of the Healthy Young Men's Study, a longitudinal mixed method study with an ethnically diverse cohort of young men who have sex with men (YMSM) (N = 526) in Los Angeles. Integral to this discussion is how a mixed methods study can address common challenges such as sampling, representation and integration of both datasets.     

The Drinking-Induced Disinhibition Scale (DIDS): a measure of three types of disinhibiting effects

Links between trait disinhibition and high-risk drinking are well established. It is also known that alcohol has disinhibiting effects. Nonetheless, there is no measure in the literature devoted exclusively to assessing disinhibiting effects of alcohol. The multidimensional Drinking-Induced Disinhibition Scale (DIDS) was developed as part of Study I, a prospective survey conducted with undergraduates (N=337). Study II, a cross-sectional survey (N=260), allowed for a confirmatory factor analysis and further validation of the measure through comparisons with an expectancies scale. The nine-item DIDS is comprised of three subscales assessing euphoric/social, dysphoric and sexual disinhibition. All three subscales had good internal consistency and adequate test-retest reliability. Convergent and discriminant validity were established in both studies. The subscales had different associations with high-risk drinking: sexual disinhibition predicted heavy episodic drinking; dysphoric disinhibition predicted alcohol-related problems and euphoric/social had associations with both. A cluster analysis revealed four distinct disinhibition profiles (i.e., low effect drinker; high euphoric/social only; high euphoric social and dysphoric; high euphoric/social and sexual), which predicted likelihood of high-risk drinking.